Preparación del paciente y ambiente quirúrgico / Patient preparation and surgical environment

El presente artículo, analiza los diferentes aspectos relacionadoscon las medidas de prevención, aplicables a la preparación delpaciente y al ambiente quirúrgico, con la finalidad de disminuir laincidencia de infecciones operatorias. Se describen todos los facto-res ambientales y funcionales, que nos ayudarán a blindar las áreasquirúrgicas y las centrales de esterilización, para ofrecer una atención quirúrgica de calidad, siguiendo las normas y procedimientosrecomendados por organismos internacionales como la OMS(AU)

This article analyses the different aspects related to preventionmeasures, applicable to patient preparedness and surgical environ-ment, in order to reduce the incidence of operating infections. Allenvironmental and functional factors are described, which will helpus to shield surgical areas and sterilization plants, to offer qualitysurgical care, following standards and procedures recommendedby international organizations such as WHO(AU)

Comparison on the Efficacy of Disinfectants Used in Automated Endoscope Reprocessors: PHMB-DBAC versus Orthophthalaldehyde

BACKGROUND/AIMS: Since endoscopes are reusable apparatus classified as semicritical item, thorough reprocessing to achieve high-level disinfection is of utmost importance to prevent spread of infection. To improve disinfection efficacy and safety, disinfectants and endoscope reprocessors are continuously evolving. This study aimed to compare the efficacy of the combination of polyhexamethylenebiguanide hydrochloride-alkyldimethylbenzylammonium chloride (PHMB-DBAC) and orthophthalaldehyde (OPA) used respectively in ultrasonographic cleaning incorporated automated endoscope reprocessors: COOLENDO (APEX Korea) or OER-A (Olympus Optical). METHODS: A total of 86 flexible upper endoscopes were randomly reprocessed with either COOLENDO/PHMB-DBAC or OER-A/OPA. Culture samplings were done at two sites (endoscope tip and working channel) which were later incubated on blood agar plate. Bacterial colonies were counted and identified. RESULTS: The culture-positive rate at the endoscope tip and working channel was 0% and 2.33% for COOLENDO/PHMB-DBAC and 4.65% and 0% for OER-A/OPA. Staphylococcus hominis was cultured from one endoscope reprocessed with COOLENDO/PHMB-DBAC and Pseudomonas putida was isolated from two endoscopes reprocessed with OER-A/OPA. CONCLUSIONS: The reprocessing efficacy of COOLENDO/PHMB-DBAC was non-inferior to that of OER-A/OPA (p=0.032; confidence interval, -0.042 to 0.042). During the study period, significant side effect of PHMB-DBAC was not observed.